Desperate race to stop the world GETTING SICK
Experimental drugs on trial in London. Teams of scientists working flat out on a vaccine. As the virus tears around the globe, a special report on the...
AS the needle slipped into Jennifer haller’s arm, the world watched and held its breath.
this was the moment last week when Jennifer became the first person to be injected with an experimental vaccine that scientists hope will help prevent future pandemics of the deadly Covid-19 coronavirus.
Mother-of-two Jennifer, 43, from Seattle, told reporters: ‘We all feel so helpless. But this is an amazing opportunity for me to do something.’
Over the next few months, hundreds more people — including many in the UK — are expected to sign up as human guinea pigs, just like Jennifer.
Last week, Boris Johnson announced that the first British patient has been put into a trial for drugs that may treat coronavirus. And a safety trial on humans, led by Oxford University, for a potential new vaccine is also expected to start next month.
this is part of a global effort, as the search gathers pace for new ways to detect, treat and prevent Covid-19.
Some, like Jennifer, will have vaccines that contain corona-like (albeit harmless) viruses injected into their bloodstream to see whether their immune systems can be trained to recognise and destroy the virus.
Others are likely to be deliberately infected with weaker versions of coronavirus and given a variety of drugs to try to stop it in its tracks. It will be science at Formula 1 pace — with some corners cut and rules bypassed.
But what does it mean to offer up your body for scientific exploration in the battle against the virus?
UK CENTRE RECRUITING HUNDREDS FOR TRIALS
In the UK, one of the centres leading the fight is FluCamp, a 24-bed privately run unit based in Whitechapel, east London, where for the past 30 years scientists have been carrying out research on cold and flu viruses.
It is the only research facility of its kind in europe — and one of just four in the world — equipped to quarantine patients for weeks at a time while they are exposed to highly infectious viruses.
Confined to one room 24 hours a day for up to a fortnight, volunteers are subject to round-the-clock testing by health professionals clad in protective clothing.
FluCamp has announced plans to recruit hundreds of healthy volunteers over the next few months. the first stage is to select 24 participants and expose them to two virus strains that are related to Covid-19 but do not wreak the same degree of havoc on the body.
A spokesman said the clinic has been inundated with more than 20,000 enquiries from would-be human guinea pigs since it unveiled its plans on March 9.
Professor John Oxford, an expert in virology at Queen Mary, University of London and scientific adviser to hVIVO — the company that runs FluCamp — says the selection process will begin in the next few weeks. ‘the plan is to test hundreds of patients but do 24 at a time, as that is how many beds the unit has,’ he says.
‘We want healthy volunteers, aged between 20 and 25, who understand the importance of remaining in isolation for long periods. But the recruitment process can be quite lengthy.’
It will probably be many months before these people are selected and subsequently given viruses.
‘A lot of applicants will be unsuitable because they drink too much alcohol, smoke or have high blood pressure,’ says Professor Oxford. ‘tests will rule these people out and include a blood test to check for any underlying or undiagnosed illnesses that might prevent them from taking part in the trial — such as type 2 diabetes.
‘In my experience, to get 100 volunteers we will need to screen around 1,000 applicants.’
VIRUSES HELPING US ATTACK CORONA
OVeR the years, FluCamp has recruited more than 2,000 people to take part in cold and flu virus research which has helped to develop new drugs and vaccines.
For example, during the past year it has been studying a new vaccine for respiratory syncytial virus (RSV), a common bug that is largely harmless in adults but can be deadly to children under the age of two. More than 80 children a year in the UK die from the infection, yet there is currently no injection to prevent it.
Once approved on a trial, volunteers are confined to one room each — some with a window, some without — that is equipped with a tV, PlayStation and wi-fi. their diet is closely controlled and no visitors can enter the facility.
the viruses to be used in tests that could eventually lead to a coronavirus vaccine are called OC43 and 229e and have been in widespread circulation around the world for many years.
‘Unlike Covid-19, which can kill by causing severe inflammation deep inside the lungs — pneumonia — they tend to affect only the upper respiratory tract — nose and throat — resulting in nothing more than symptoms of the common cold,’ says Professor Oxford.
the two viruses share the same structure and shape as Covid-19, so they are ideal for testing treatments that could destroy it without exposing patients to high risk.
But scientists are confident that by studying the behaviour of these two viruses in the body and how they respond to different treatments, they will discover weak spots that could act as targets for drugs to protect people from catching Covid-19, and reduce the risk of dying in those who have it.
ARE THERE RISKS TO VOLUNTEERS?
thIS KInd of trial — where healthy people are deliberately infected with a virus to see how it spreads in the body — is called a controlled human infection model. It is a method deployed when scientists need to speed up the search for lifesaving treatments.
normally the process takes months and involves vaccinating thousands of people in a largescale trial, then waiting to see
whether they catch a virus that is circulating in the community.
The initial phase of this coronavirus research will focus on whether the two selected virus strains are a good ‘model’ for investigating ways to tackle it.
Participants will have samples of each virus inserted in their noses and will then be closely monitored for signs of infection, such a fever.
Tests include taking blood samples to check volunteers’ DNA, to see if there are any particular genes that might be switched on by the virus, triggering infection. If so, those genes could potentially be a target for a treatment that might switch them off again.
As the search continues, FluCamp will extend the process to testing vaccines and drugs developed by other pharmaceutical companies around the world.
Professor Oxford insists that the dangers to volunteers — who will reportedly be paid up to £3,500 each for their two-week quarantine stint — are minimal.
LESSONS FROM FAILED TRIALS
YET for all the assurances, experiments on human guinea pigs can go catastrophically wrong.
In 2006, a clinical trial at Northwick Park Hospital, in London, hit the headlines when six previously healthy young men became critically ill after being given an experimental drug — TGN1412 — for leukaemia and rheumatoid arthritis.
They all went into organ failure and were rushed to intensive care, though all eventually recovered.
Once Covid-19 testing moves on to candidate vaccines, scientists at FluCamp will be closely monitoring the response of the immune system to see how well it does at producing cells called Tcells as a result of vaccination.
When the body is invaded by bacteria, viruses or parasites, an alarm sounds in the immune system, which dispatches a range of cells that make up the first line of defence to attack the invader.
One such cell type are macrophages, produced in bone marrow, which destroy foreign cells by pulling apart the proteins that hold them together. Sometimes, when the body needs a more sophisticated attack — which is likely with a new virus such as Covid-19 — it turns to the immune system’s T-cells and B-cells. These can hunt down rogue invaders by recognising their molecular signature from previous encounters, such as through a vaccine.
COULD OLD DRUGS DO THE TRICK?
ACCOrDING to the World Health Organisation, up to 35 different Covid-19 vaccines are already in development. The frontrunner — given to Jennifer Haller in the U.S. last week — is mrNA-1273.
It is being given in one of three different doses to 45 healthy recruits, initially to make sure the vaccine is safe. Once that is established, larger-scale testing will begin to see whether it protects against Covid-19 infection.
The vaccine targets a particular protein — called the spike protein — found on the surface of Covid-19 cells. The vaccine is made with a tiny fragment of the genetic material that makes this protein.
It will not spark infection when it is injected into the bloodstream, but will help the immune system to recognise it as an invader and be ready to attack if it later encounters the virus itself.
Even if all goes well, the mrNA1273 jab is unlikely to be available for widespread use before 2021.
That is one reason why some
British experts are pinning their hopes on the ‘repurposing’ of existing drugs to treat Covid-19, as this could deliver a solution faster.
Dozens of established medicines are being tested as candidates, including antiviral drugs originally invented to tackle Ebola, and antiinflammatory medicines used to treat rheumatoid arthritis.
‘I am very optimistic that some of these drug treatments can help,’ says Peter Openshaw, a professor of experimental medicine at Imperial College London. ‘They are hot candidates.’
Professor Oxford adds: ‘I am more hopeful about the use of existing antiviral drugs than a vaccine any time soon.
‘We have clear experience with these drugs already and they can be easily repurposed to be used in the fight against this virus. But it is going to take a huge international effort.’